Muscle knots in the Teres Major are typically located at the lower edge of the shoulder blade, where the muscle connects to the upper arm bone (humerus). These muscle knots often refer pain to the top of the shoulder, back of the shoulder, down the back of the upper arm, and into the forearm, sometimes skipping the elbow entirely. You may feel a deep ache or sharp pain when reaching overhead, pulling, or even just resting their elbows on a table.